Deep vicariance and frequent transoceanic dispersal shape the evolutionary history of a globally distributed fern family.

PREMISE: The historical biogeography of ferns is typically expected to be dominated by long-distance dispersal due to their minuscule spores. However, few studies have inferred the historical biogeography of a large and widely distributed group of ferns to test this hypothesis. Our aims were to determine the extent to which long-distance dispersal vs. vicariance have shaped the history of the fern family Blechnaceae, to explore ecological correlates of dispersal and diversification, and to determine whether these patterns differ between the northern and southern hemispheres. METHODS: We used sequence data for three chloroplast loci to infer a time-calibrated phylogeny for 154 of 265 species of Blechnaceae, including representatives of all genera in the family. This tree was used to conduct ancestral range reconstruction and stochastic character mapping, estimate diversification rates, and identify ecological correlates of diversification. RESULTS: Blechnaceae originated in Eurasia and began diversifying in the late Cretaceous. A lineage comprising most extant diversity diversified principally in the austral Pacific region around the Paleocene-Eocene Thermal Maximum. Land connections that existed near the poles during periods of warm climates likely facilitated migration of several lineages, with subsequent climate-mediated vicariance shaping current distributions. Long-distance dispersal is frequent and asymmetrical, with New Zealand/Pacific Islands, Australia, and tropical America being major source areas. CONCLUSIONS: Ancient vicariance and extensive long-distance dispersal have shaped the history of Blechnaceae in both the northern and southern hemispheres. The exceptional diversity in austral regions appears to reflect rapid speciation in these areas; mechanisms underlying this evolutionary success remain uncertain.

[Euthanasia laws in Spain and in the world: Medical aspects]. / Leyes de eutanasia en España y en el mundo: aspectos médicos.

OBJECTIVE: To compare the Spanish law on euthanasia and assisted suicide with those that exist in other countries. DESIGN: Systematic review of the bibliography. DATA SOURCES: Medline/PubMed, EMBASE and the Cochrane Library were searched for studies that contained in their title or abstract the descriptors «euthanasia¼ or «assisted suicide¼ and also «legislation¼ or «law¼, between 2002 and the end of 2020. STUDY SELECTION: The search found 1647 studies and after screening 663 were assessed, of which 30 were included in the review. Studies that only contained opinions or did not provide data on euthanasia/assisted suicide in the countries that have them regulated were rejected. DATA EXTRACTION: We registered the criteria that regulate the acceptance or rejection of a request for euthanasia or assisted suicide in Spain and in the other countries where they are decriminalized. RESULTS: The euthanasia regulations in the world can be grouped into three groups: laws that allow euthanasia and assisted suicide (Netherlands, Belgium, some states of Australia, New Zealand, Spain), those in which the law only allows assisted suicide (USA) and those in which only assisted suicide is admitted and based on court decisions, without specific legislation (Switzerland, Germany). CONCLUSIONS: Although there are differences, the laws that the Spanish euthanasia law most closely resembles are those of the Netherlands and Belgium, so it is foreseeable that the casuistry of euthanasia and its figures in Spain will resemble that of those countries in the future.

Suicide in primary headaches in 48 countries: A physician-survey based study.

Aim To investigate the relationship between primary headache types and accomplished or attempted suicide in countries from all world regions. Methods Data were obtained using a questionnaire about suicide due to headache in a face-to-face interview with 203 physicians with expertise in headaches. They came from 48 countries, and from all continents. Results Primary headaches cause one suicide per 1,000,000 population each year (1% of the suicide rate due to all causes). Cluster headache and migraines account for 70-80% of them. Suicide attempts are 10 times more frequent than accomplished suicides. Cluster headache poses more risk than migraine. This risk is not often acknowledged, and is increased if there is previous psychiatric history. More than half of the physicians interviewed think it could be reduced with a more aggressive treatment of headaches. Conclusions Cluster headache and migraine are not always benign, and are the cause of the majority of suicides due to headache.

Functionality and Quality of Life with Parkinson's Disease after Use of a Dynamic Upper Limb Orthosis: A Pilot Study.

Parkinson's disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson's disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales.

Placebo effect characteristics observed in a single, international, longitudinal study in Huntington's disease.

BACKGROUND: Classically, clinical trials are based on the placebo-control design. Our aim was to analyze the placebo effect in Huntington's disease. METHODS: Placebo data were obtained from an international, longitudinal, placebo-controlled trial for Huntington's disease (European Huntington's Disease Initiative Study Group). One-hundred and eighty patients were evaluated using the Unified Huntington Disease Rating Scale over 36 months. A placebo effect was defined as an improvement of at least 50% over baseline scores in the Unified Huntington Disease Rating Scale, and clinically relevant when at least 10% of the population met it. RESULTS: Only behavior showed a significant placebo effect, and the proportion of the patients with placebo effect ranged from 16% (first visit) to 41% (last visit). Nondepressed patients with better functional status were most likely to be placebo-responders over time. CONCLUSIONS: In Huntington's disease, behavior seems to be more vulnerable to placebo than overall motor function, cognition, and function

Aurochs roamed along the SW coast of Andalusia (Spain) during Late Pleistocene.

In the Iberian Peninsula the fossil record of artiodactyls spans over 53 million years. During the Pleistocene, wild cattle species such as Bison and especially Bos became common. In Late Pleistocene, the aurochs (Bos primigenius) was widespread and the only bovine living along the large river valleys of southern Iberia. Although commonly found in fossil sites and especially in cave bone assemblages, the trace fossil record of aurochs was known worldwide only from the Holocene. Large bovine and roe deer/caprine tracks were found in at least five horizons of the early Late Pleistocene (MIS 5) beach and eolian deposits of Cape Trafalgar (Cadiz Province, South of Spain). The large bovine tracks are formally described as Bovinichnus uripeda igen. et isp. nov. and compared with the record of aurochs tracks, large red deer tracks and steppe bison biogeographical distribution in Iberia. Aurochs were the most likely producers of the newly described Trafalgar Trampled Surface (TTS) and some of the large artiodactyl tracks in the Matalascañas Trampled Surface, representing the oldest aurochs track record known. This new evidence, together with comparisons with the record of possible aurochs tracks in the Mid-Late Pleistocene coastal deposits from the Asperillo cliff section in Matalascañas (Huelva Province, SW Spain) and bone assemblages known in Gibraltar, point to a recurrent use of the coastal habitat by these large artiodactyls in SW Iberia.

Validation of screening instruments for neuroepidemiological surveys of tic disorders.

BACKGROUND: The main purpose was to validate a multistage protocol to screen tic disorders in mainstream and special education centers and to investigate whether telephone-based interviews were accurate to diagnose tic disorders when compared with in-person neurological interviews. METHODS: A school-based survey of children and adolescents (6-16 years). A proxy report questionnaire for tic disorders was completed by teachers, observers, and parents. The diagnosis was confirmed by the neurologist based on the Diagnostic and Statistical Manual of Mental disorders (DSM-IV TR) criteria. The sensitivity, specificity, positive and negative predictive values, the likelihood ratio for a positive result (LR+), and the Kappa coefficients (k) for telephone-based interviews reliability were calculated. RESULTS: One hundred twenty subjects, 57 from special education center and 63 from a mainstream school were studied. The sensitivity of the proxy report questionnaire was 58% and 36% when completed by the observers (mainstream and special education center, respectively), 40 and 73% when completed by the teachers, and 58 and 36% when completed by the parents. Using any of these 3 screening sources, the sensitivity was 92%, the positive predictive value was 38%, and negative predictive value was 97% (mainstream schools), whereas the sensitivity was 82%, the positive predictive value was 20%, and negative predictive value was 82% (special education centers). Parents (mainstream schools) and teachers (special education center) produced the highest LR+ (7.25 and 1.26, respectively) and the intraobserver reliability of the telephone-based interviews versus in-person neurological interviews gave a k coefficient of 0.83. CONCLUSIONS: The efficiency of different screening instruments for tic disorders seems to vary in different settings. Telephone-based interviews may be a valid and convenient backup to ascertain the diagnosis of tic disorders when face-to-face neurological examination is not possible.

Biometry of stomata in Blechnum species (Blechnaceae) with some taxonomic and ecological implications for the ferns.

Morphological stomatal traits, such as size, form and frequency, have been subject of much literature, including their relationships with environmental factors. However, little effort have focused on ferns, and very few in the genus Blechnum. Stomatal length, width and frequency (as stomatal index) of a number of specimens of fourteen Neotropical species of Blechnum were measured in adult pinnae. The aim of the work was to find biometrical relationships between stomatal traits and between stomatal traits and habit, habitat and ecosystem of the plants. Statistical analyses of data were conducted using Exploratory Data Analysis and Multivariate Statistical Methods. Stomatal length and width showed a very high correlation, suggesting an endogenous, genetic control, thus giving these traits a considerable diagnostic utility. With respect to the relationships between stomatal traits and environment, we found significant statistical relationships between altitude and stomatal index. We also addressed the interpretation of the ecological-selective significance of various assemblages of stomatal traits in a diverse conjunction of habits, habitats and ecosystems.

First tracks of newborn straight-tusked elephants (Palaeoloxodon antiquus).

Tracks and trackways of newborns, calves and juveniles attributed to straight-tusked elephants were found in the MIS 5 site (Upper Pleistocene) known as the Matalascañas Trampled Surface (MTS) at Huelva, SW Spain. Evidence of a snapshot of social behaviour, especially parental care, can be determined from the concentration of elephant tracks and trackways, and especially from apparently contemporaneous converging trackways, of small juvenile and larger, presumably young adult female tracks. The size frequency of the tracks enabled us to infer body mass and age distribution of the animals that crossed the MTS. Comparisons of the MTS demographic frequency with the morphology of the fore- and hind limbs of extant and fossil proboscideans shed light into the reproductive ecology of the straight-tusked elephant, Palaeloxodon antiquus. The interdune pond habitat appeared to have been an important water and food resource for matriarchal herds of straight-tusked elephants and likely functioned as a reproductive habitat, with only the rare presence of adult and older males in the MTS. The preservation of this track record in across a paleosol surface, although heavily trampled by different animals, including Neanderthals, over a short time frame, permitted an exceptional view into short-term intraspecific trophic interactions occurring in the Last Interglacial coastal habitat. Therefore, it is hypothesized that Neanderthals visited MTS for hunting or scavenging on weakened or dead elephants, and more likely calves.

Impact of COVID-19 outbreak on ischemic stroke admissions and in-hospital mortality in North-West Spain.

BACKGROUND AND PURPOSE: Spain has been one of the countries heavily stricken by COVID-19. But this epidemic has not affected all regions equally. We analyzed the impact of the COVID-19 pandemic on hospital stroke admissions and in-hospital mortality in tertiary referral hospitals from North-West Spain. METHODS: Spanish multicenter retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. We recorded the number of patients admitted for ischemic stroke between 30 December 2019 and 3 May 2020, the number of IVT and EVT procedures, and in-hospital mortality. RESULTS: In the study period, 2737 patients were admitted with ischemic stroke. There was a decrease in the weekly mean admitted patients during the pandemic (124 vs. 173, p<0.001). In-hospital mortality of stroke patients increased significantly (9.9% vs. 6.5%, p = 0.003), but there were no differences in the proportion of IVT (17.3% vs. 16.1%, p = 0.405) or EVT (22% vs. 23%, p = 0.504). CONCLUSION: We found a decrease in the number of ischemic stroke admissions and an increase in in-hospital mortality during the COVID-19 epidemic in this large study from North-West Spain. There were regional changes within the network, not fully explained by the severity of the pandemic in different regions.

Tremor Control Devices for Essential Tremor: A Systematic Literature Review.

Background: There is a growing interest in nonpharmacological approaches for essential tremor (ET), including tremor cancelation devices. However, the true efficacy of such devices in ET remains unclear. Methods: A systematic literature review was conducted using standardized criteria regarding efficacy and comfortability. Devices focused on design or experimental testing in which tremor was simulated in a robot were excluded. Results: Out of 324 articles initially identified, 12 articles were included. Orthoses using biomechanical loading and neuromodulation with electrical stimulation, and external tremor cancelation devices, were the main interventions used to suppress tremor. All devices were designed to control tremor of the upper limbs at different anatomical locations. Overall, an average tremor attenuation of 50-98% was reported (level of evidence III). Interference with voluntary movements and portability was described as the main drawback. Discussion: In conclusion, this review highlights the growing interest in emerging tremor control devices and the importance of assessing comfort without affecting voluntary movements. However, the level of evidence regarding the efficacy of these tremor control devices remains low. An integrated multidisciplinary combination approach of engineering, robotics, physiology, physiotherapy, and clinical assessment is needed to improve the quality of non-pharmacological interventions for ET.

Sporophyte morphology and gametophyte development of the fern Blechnum sprucei (Pteridophyta: Blechnaceae).

The fern Blechnum sprucei grows in Mesoamerica (Costa Rica) and South America, from Colombia to Bolivia, SE and centre of Brazil, Paraguay and Argentina. It is a distinctive, somewhat vulnerable, mostly orophilous species. Fresh and dry herbarium material was used for this study. Herbarium material for anatomical studies comes from CTES, BA, LP, MA, SI and UC (Holmgren et al. 1990). Selected representative specimens are additionally cited after taxonomic treatment of the species. Dry material was restored with aqueous 4:1 butil cellosolve. Pinnae were cleared with aqueous 6% NaOH, then coloured with aqueous 1% TBO (Gurr 1966). Hand made transverse sections of young and adult stipes, and costae were done in fresh and restored herbarium material. Venation and epidermal patterns were analyzed in basal, apical and medium pinnae, but only the latter were illustrated. The size and density of stomata were measured in medium pinnae from all studied samples, values shown are the average of 25 measures per sample; sizes are expressed as minimum, media and maximum length x width, in microm, and density as minimum, media and maximum number of stomata/ mm2. Spores were studied with SEM, mounted on metal stubs with double sided tape, covered with gold under vacuum and photographed with a Jeol /EO JSM 6360 (15 KV) SEM. Spores were also studied with light microscope, mounted in DePeX (DePeX mounting medium, Gurr, BDH Laboratory Supplies, Poole BH15 1TD, UK) and measured using an ocular micrometer. Measurements are based on a minimum sample of 100 spores taken from different specimens. Sizes are expressed as the longest equatorial diameter/ polar diameter, in microm. Gametophytes were studied from material collected in the subtropical forest of Tucumán Province, Argentina. Spore samples for cultures were taken from single sporophytes kept dry at room temperature since the date plants were collected. Gametophytes were grown under fluorescent light. Multispore cultures were established on mineral agar. Percentage of germination was recorded for a random sample of 50 spores from each of the two plates, every three days until there was no further increasing. Gametophytes were stained with chloral hydrate acetocarmine. The species has large sporophytes, suberect, scaly rhizomes, and dimorphic fronds with short, scaly stipes and lanceolate to elliptic sterile laminae. The rachises can grow indefinitely as radicant axis that vegetatively multiplicate the plants. Pinnae are lanceolate, herbaceous, with crenate and papillose margins, superficially scaly and hairy, peciolulate, with free, visible veins regularly once furcated near the coast, ending in large, active hydathodes. The broadly elliptic fertile laminae bear distant pinnae, with vegetative tissue reduced to the portion that supports the indusium and the continuous coenosorus; terminal indefinite rachis, not proliferous, may be present.

Germination fitness of two temperate epiphytic ferns shifts under increasing temperatures and forest fragmentation.

Ferns are an important component of ecosystems around the world. Studies of the impacts that global changes may have on ferns are scarce, yet emerging studies indicate that some species may be particularly sensitive to climate change. The lack of research in this subject is much more aggravated in the case of epiphytes, and especially those that live under temperate climates. A mathematical model was developed for two temperate epiphytic ferns in order to predict potential impacts on spore germination kinetics, in response to different scenarios of global change, coming from increasing temperature and forest fragmentation. Our results show that an increasing temperature will have a negative impact over the populations of these temperate epiphytic ferns. Under unfragmented forests the germination percentage was comparatively less influenced than in fragmented patches. This study highlight that, in the long term, populations of the studied epiphytic temperate ferns may decline due to climate change. Overall, epiphytic fern communities will suffer changes in diversity, richness and dominance. Our study draws attention to the role of ferns in epiphytic communities of temperate forests, emphasizing the importance of considering these plants in any conservation strategy, specifically forest conservation. From a methodological point of view, the model we propose could be easily used to dynamically monitor the status of ecosystems, allowing the quick prediction of possible future scenarios, which is a crucial issue in biodiversity conservation decision-making.

Prevalence of tics in schoolchildren in central Spain: a population-based study.

Tic disorders constitute a neurodevelopmental disorder of childhood. This study sought to determine the prevalence of tic disorders in a school-based sample. A randomized sample of 1158 schoolchildren, based on clusters (classrooms) in the province of Burgos (Spain), was identified on a stratified sampling frame combining types of educational center and setting (mainstream schools and special education), using a two-phase approach (screening and diagnosis ascertainment by a neurologist). Tics with/without impairment criterion were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria. In mainstream schools, tics were observed in 125/741 students (16.86%; 95% confidence interval, 14.10-19.63), and were more frequent in boys (87/448, 19.42%; 95% confidence interval, 15.64-23.19) compared with girls (38/293, 12.96%; 95% confidence interval, 8.95-16.98; P = 0.03). In special education centers, tics disorders were observed in 11/54 of children (20.37%; 95% confidence interval, 8.70-32.03). Overall, tics with impairment criteria were less frequent than tics without impairment criteria (4.65% vs 11.85%, P < 0.0001). The most frequent diagnoses involved chronic motor tics (6.07%) and Tourette syndrome (5.26%). Tic disorders are common in childhood, and the use or nonuse of impairment criteria exerts a significant impact on tic prevalence estimates.